DVLA update driving regulations for patients with sleep apnoea

Wednesday, November 1, 2017

On behalf of the OSA Partnership Group, Professor John Stradling provides an overview of the updated DVLA guidance on Obstructive Sleep Apnoea (OSA) and driving. The OSA Partnership Group was set up in 2012 to raise awareness of the condition.

Up until January 2016 the DVLA regulations for OSA patients with sleepiness affecting their driving were workable and allowed a degree of flexibility. However a new EU directive, intended to harmonise the rules across the EU, was poorly translated by UK lawyers into a new set of regulations, and inappropriately emphasised the AHI or equivalent.

The main problem was that the wording seemed to imply that in some situations driving should cease (and the DVLA informed) even if there were no symptoms, and before a provisional diagnosis had been confirmed. This caused great confusion and almost certainly led to considerable anxiety over the possible and unnecessary loss of a driving licence. It was clear something had to change and extensive communications and meetings were had between the OSA Alliance, a group set up for specifically to address the issue which comprises of OSA partnership group, BTS, BSS, ARTP and other interested parties, with the DVLA.

Discussions were protracted but I am pleased to say ultimately successful. The new workable guidelines were agreed and accepted in October 2017. They are much more pragmatic and align more with rules about other medical problems. They are not perfect but, given the EU directive and the greyness of many aspects of OSA and driving, they are probably the best achievable.

The essential features are that it is clear that stopping driving depends on the presence of sleepiness ‘having, or likely to have, an adverse effect on driving’ (for whatever reason). If OSA is suspected as the explanation for such sleepiness then driving must cease of course, but the DVLA do not need to be informed until a diagnosis of OSAS has been confirmed (i.e. the sleepiness is diagnosed as being due to the OSA on a sleep study). Once the diagnosis of OSA as the cause has been made, then the DVLA need to be notifiedby the patient.

We would recommend that the patient writes to the DVLA (rather than ringing) to ensure a consistent response. Hopefully units will be able to quickly treat such patients, so that when the DVLA writes back to the patient with an SL1 form to fill in, the treated patient can honestly say they are no longer sleepy. The EU directive also demands some form of check every 3 years for Type 1 licence holders and every year for Type 2 licence holders, that confirm the patient’s symptoms remain under control, although the exact requirements for this are as yet unclear."